Katzman R, Brown T, Thal L J, Fuld P A, Aronson M, Butters N, Klauber M R, Wiederholt W, Pay M, Xiong R B
Department of Neurosciences, University of California, San Diego.
Ann Neurol. 1988 Sep;24(3):384-9. doi: 10.1002/ana.410240306.
Longitudinal studies of subjects with autopsy-proven Alzheimer's disease in one skilled nursing home and of clinically diagnosed cases (NINCDS/ADRDA criteria) in three community cohorts are compared with regard to the annual rate of change in the error score of the Blessed information-memory-concentration test (IMC) in which the maximum number of errors possible is 33. The four cohorts differed significantly from each other in regard to age, education, sex, and the degree of dementia as measured by the initial IMC score. Subjects spanned the age range of 52 to 96 years and had 2 to 20 years of education. The rate of change in error score per year was similar whether the initial error score was 0 to 7, 8 to 15, or 16 to 23; however, the rate was reduced when the initial error score was 24 or above, due to a ceiling effect of the test. Among subjects with initial IMC scores less than 24, the annual rate of change varied considerably. However, the mean annual rate of change, 4.4 errors (SD +/- 3.6, SEM +/- 0.3) per year, was independent of residence in a nursing home, location of the study site, and of the patient's sex or education. Of particular importance was the finding that the rate of change in mental test score was independent of age. It can be concluded that the rate of cognitive deterioration in patients with Alzheimer's disease is quite variable among individuals and is independent of the patient's age and whether the patient resides in the community or in a nursing home.(ABSTRACT TRUNCATED AT 250 WORDS)
对一家专业疗养院中经尸检证实患有阿尔茨海默病的受试者，以及三个社区队列中临床诊断病例（采用美国国立神经疾病与中风研究所/阿尔茨海默病及相关疾病协会标准）进行纵向研究，比较了Blessed信息-记忆-注意力测试（IMC）错误分数的年变化率，该测试的最大错误数为33。这四个队列在年龄、教育程度、性别以及通过初始IMC分数衡量的痴呆程度方面存在显著差异。受试者年龄跨度为52至96岁，教育年限为2至20年。无论初始错误分数是0至7、8至15还是16至23，每年错误分数的变化率相似；然而，当初始错误分数为24或更高时，由于测试的天花板效应，变化率会降低。在初始IMC分数低于24的受试者中，每年的变化率差异很大。然而，平均每年变化率为4.4个错误（标准差±3.6，标准误±0.3），与是否住在疗养院、研究地点以及患者的性别或教育程度无关。特别重要的是，心理测试分数的变化率与年龄无关这一发现。可以得出结论，阿尔茨海默病患者认知衰退的速度在个体间差异很大，且与患者年龄以及患者是居住在社区还是疗养院无关。（摘要截短至250字）
